脑卒中患者健康信念简表的信效度检验

The reliability and validity of short form health belief model scale for stroke patients

目的为了更简便地测量脑卒中患者的健康信念水平,将Champion健康信念量表(the champion health belief model scale,CHBMS)中文版进行简化。方法对88例患者的CHBMS健康信念量表的完整中文版问卷进行条目分析,并采用专家咨询法进行修订并简化为健康信念简表(short form fealth belief model scale,SFHBMS),并对235例脑卒中患者问卷调查,采用SPSS 17.0及Mplus 7.0软件检验简表的信度和效度。结果简化后的量表的条目水平内容效度指数(item-level content validity index,I-CVI)平均为0.97,量表水平的全体一致内容效度指数(sale-content validity index/universal agreement,S-CVI/UA)和平均内容效度指数(sale-content validity index/average,S-CVI/Ave)分别为0.85、0.97;总量表的同质性信度、分半信度、重测信度分别为0.835、0.779、0.811;验证性因子分析模型的常态化卡方值(χ~2/df)为1.642,比较拟合指数(comparative fit index,CFI)为0.939,Tucker-Lewis指数(tucker-lewis index,TLI)为0.926,标准化残差均方根(standardized root mean square residual,SRMR)为0.062,近似误差平方根(root mean square error of approximation,RMSEA)为0.052,P=0.361,说明模型精确拟合数据。简表与完整版量表的效标效度为0.956。SF-HBMS能区分不同文化程度患者的健康信念水平(t=-2.282,P=0.023),区分效度较好。结论 SF-HBMS具有较好的信度和效度,可用于测量脑卒中患者的健康信念水平。

Objective To simplify the Chinese version of the champion health belief model scale （CHBMS）. Methods The Chinese version of CHBMS was revised using item analysis and expert consultation methods. A total of 235 stroke patients were recruited and investigated with short form health belief model scale （SF-HBMS）. SPSS 17.0 and Mplus 7.0 software were used to test the reliability and validity. Results The item-level content validity index（I-CVI） was 0. 97. The Sale-CVI/universal agreement （S-CVI/UA） was 0. 85. The Sale-CVI/average （S-CVI/Ave） was 0. 97. The Cronbach＇ sot was 0. 835. The split-half reliability was 0. 779. The test-retest reliability was 0. 811. The confirmatory factor analysis was performed to test the construct validity. The Z2/ df was 1. 642： The comparative fit index （ CFI ） was 0. 939. The tucker-lewis index （TLI） was 0. 926. The standardized root mean square residual. （SRMR） was 0. 062; the root mean square error of approximation （RMSEA）was 0. 052, P = 0. 361, which all demonstrated that six dimensions and their items were all consistent and fitted with its theoretical structure. The criterion-related validity was0. 956. It could distinguish the difference of health belief among patients with different educational level （ t = -2. 282 ,P = 0. 023 ） and had desired discriminative validity. Conclusions The SF-HBMS has satisfactory reliability and validity, and can be used to assess the level of health belief for stroke patients.